Gait Recovery in Spinal Cord Injury: A Systematic Review with Metanalysis Involving New Rehabilitative Technologies

Brain Sci., 2023 · DOI: 10.3390/brainsci13050703 · Published: April 22, 2023

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study reviews new methods for helping people with spinal cord injuries walk better. It looks at studies from the last 10 years that test things like robotic training, external stimulation, and methods that change oxygen levels. The review found some evidence that robotic devices and other methods can improve walking, but more research is needed.

Study Duration

Not specified

Participants

Adults with non-progressive spinal cord injury

Evidence Level

Systematic Review and Meta-analysis of 18 RCTs

Key Findings

1
Weak evidence suggests robotic devices may lead to better gait independence outcomes compared to conventional rehabilitation.
2
External stimulation and intermittent hypoxia appear to improve gait parameters when combined with other rehabilitation methods.
3
There is a sufficient magnitude of WISCI-II with ES (Effect Size) = 0.23 (ES > 0.2) for robotic rehabilitation methods.

Research Summary

This systematic review investigates the use of innovative rehabilitation approaches in patients with SCI. For the ﬁrst time ever, we have gone beyond robotics since our study also focuses on other promising protocols, paving the way for more personalized training. We observed, with low evidence, that robot-assisted gait rehabilitation, alone or associated with other methods (e.g., Biofeedback EMG), leads to improvement in gait function and independence, in comparison to conventional therapy alone.

Practical Implications

Personalized Training

The study highlights the potential for personalized training approaches by considering various rehabilitation methods beyond robotics.

Rehabilitation Dosage

Robotics rehabilitation relieves the care to acquire the same therapeutic dosage we can deliver with traditional methods using fewer human resources.

Combined Therapies

Combining external stimulation (TMS) with robotic rehabilitation shows promise for enhanced functional recovery in SCI patients.

Study Limitations

1
Lack of large sample trials with good homogeneity of data
2
Lack of long-term follow-up
3
Limited comparable outcome data for external stimulation and intermittent hypoxia, restricting meta-analysis.

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